<HTML>
	<HEAD>
		<SCRIPT TYPE="text/javascript" SRC="/jaxcent21.js"></SCRIPT>
		<img border="4" src="images/forum_is_nice.jpg" width="1192" height="200" />

	</HEAD>
	<BODY style="background-color:PaleTurquoise;">
		<table width="1200" id="header" border="1" cellspacing="10" bgcolor="LightSeaGreen">
			<tr>
				<td>template header</td>
			</tr>
		</table>
		<p id="username"> username </p>
		<br>
		<fieldset>
			<legend style="text-align:center;font-size:50px">
			<b>Edit Profile:</b></legend>
			<br>
			<form style="font-size:20px">
				<input id="changePass" type="checkbox" name="changePass"> Change password </input>
				<br><br>
				Password:
				<input id="pass" type="password" name="password"/>
				<br><br>
				New Password:
				<input id="newPass" type="password" name="NewPassword"/>
				Verify Password:
				<input id="passVerify" type="password" name="verifyPass"/>
				<br><br>
				First Name:
				<input id="firstName" type="text" name="firstname" />
				Last Name:
				<input id="lastName" type="text" name="lastname" />
				<br><br>
				Residence:
				<input id="residence" type="text" name="residence" />
				<br><br>
				<input id="dateBirth" type="checkbox" name="dateBirth"> check this to change date </input>
				<br>
				Date of birth:
				<select id="birthDay"> </select>
				<select id="birthMonth"> </select>
				<select id="birthYear"> </select>
				<br><br>
				Gender:
				<input id="maleGender" type="radio" name="sex" value="male" /> Male
				<input id="femaleGender" type="radio" name="sex" value="female" /> Female
				<br><br>
				<button id="saveChange" type="button" >Save Changes</button>
				<input type="reset" value="Reset"/>
				<P id="parError" style="color:red;font-size:20px"></P>
			</form>
		</fieldset>




		<br>
		<P id="footer">template footer</P>

	</BODY>
</HTML>
